Deaf persons' english reading levels and associations with epidemiological, educational, and cultural factors.

One hundred six Michigan d/Deaf persons, part of a study evaluating how to improve d/Deaf persons' understanding of cancer prevention recommendations, had reading levels determined using the Test of Reading Comprehension, Syntactic Sentences. Respondents averaged 52 years old, 59% female, 84% Caucasian, 58% married, and 75% Deaf community members. The mean Test of Reading Comprehension, Syntactic Sentences score was 6.

Effectiveness of videos improving cancer prevention knowledge in people with profound hearing loss.

Deaf persons have a poorer understanding of cancer prevention, which is felt to be partly due to communication barriers. One hundred ninety-seven d/Deaf persons completed a survey and video on cancer prevention. Half viewed a spoken English program designed for hearing persons (control group); the other half viewed an amended program that had American Sign Language, captions, and printed English options added (experimental group).

Football (soccer) safety equipment use and parental attitudes toward safety equipment in a community youth sports program.

While a growing number of children are playing football (soccer), there are limited data on prevalence of injuries, actual use of football safety equipment (SE), and parental attitudes about football SE. We distributed a self-administered survey by mail to parents of all players enrolled in a community recreation youth football program. Parents of 865 children responded.

Cancer prevention knowledge of people with profound hearing loss.

Background: Deaf persons, a documented minority population, have low reading levels and difficulty communicating with physicians. The effect of these on their knowledge of cancer prevention recommendations is unknown.

Methods: A cross-sectional study of 222 d/Deaf persons in Michigan, age 18 and older, chose one of four ways (voice, video of a certified American Sign Language interpreter, captions, or printed English) to complete a self-administered computer video questionnaire about demographics, hearing loss, language history, health-care utilization, and health-care information sources, as well as family and social variables.

An integrative medicine patient care model and evaluation of its outcomes: the University of Michigan experience.

Background: The demand for integrative medicine care is increasing rapidly among patient consumers, yet the integrative medicine model is not the norm in clinical practice, nor is this approach a focus in traditional medical schools. Furthermore, patient well-being and satisfaction outcomes within an integrative care model are not common in the literature.

Objectives: The purpose of this paper is to offer a summary of a model of integrative medicine patient care and its evaluation and outcomes from the University of Michigan Integrative Medicine Clinic.

Vulvodynia incidence and remission rates among adult women: a 2-year follow-up study.

Objective: To estimate the incidence and remission rates of vulvodynia over a 2-year period.

Methods: A 2-year follow-up survey was sent to the University of Michigan Women's Health Registry members who had participated in a previously reported, validated survey. Changes in clinical status, incidence, and remission rates for vulvodynia were estimated, as were factors associated with new onset or remission of symptoms, using univariable and multivariable analyses.

Depression and pain in retired professional football players.

Purpose: To assess the prevalence of depressive symptoms and difficulty with pain in retired professional football players, difficulties with the transition from active athletic competition to retirement, perceptions of barriers to receiving assistance for those difficulties, and recommended programs to provide such assistance.

Methods: Survey sent to 3377 retired members of the National Football League Players Association (NFLPA), with usable responses received from 1617 members (functional response rate, 48.6%).

Treatment of vulvodynia with tricyclic antidepressants: efficacy and associated factors.

Objective: To determine the efficacy of tricyclic antidepressants (TCAs) as treatment for vulvodynia, and to identify demographic factors and pain characteristics associated with improvement.

Materials And Methods: Between January 2001 and April 2004, women diagnosed with vulvodynia were offered TCA therapy. The patients rated their worst recent pain on a 10-point scale at baseline and at follow-up; improvement was classified as at least 50% reduction in reported pain from baseline.

Reliability and validity of self-reported symptoms for predicting vulvodynia.

Objective: To evaluate the reliability and validity of self-reported symptoms to predict vulvodynia, compared with examination-based confirmation.

Methods: Between August 5, 2004, and December 13, 2004, 1,046 members of the University of Michigan Women's Health Registry were surveyed regarding the presence of symptoms suggestive of vulvodynia. Diagnoses of vulvodynia and of control status based on survey responses were made, and a subset of these respondents was evaluated in the office.

Residency education through the family medicine morbidity and mortality conference.

Background And Objectives: The value of the morbidity and mortality conference (M&MC) has received little examination in the primary care literature. We sought to understand the educational content of M&MCs by examining data from a family medicine training program.

Methods: Archived morbidity and mortality conference data (July 2001-July 2003) were retrieved from two University of Michigan family medicine adult inpatient services (one community based and one university based).

Physician experience with family presence during cardiopulmonary resuscitation in children.

Objective: Family presence during cardiopulmonary resuscitation in children is an emerging practice. Although many hospitals allow this practice, there is scant research on physician attitudes and opinions and on physician views about training for resident physicians.

Design: Survey method.

Pre-exercise stretching and sports related injuries: knowledge, attitudes and practices.

Objective: Pre-exercise stretching (PES) has been common practice prior to participation in athletic events. Despite evidence for lack of benefit, many coaches continue to routinely instruct and prescribe stretching. This study assesses the knowledge, attitudes and practices of high school coaches regarding PES.

Assessment of depressive symptoms in deaf persons.

Background: Evidence suggests that Deaf people may have a greater prevalence of depressive symptoms. However, it is unclear whether commonly used written screening instruments are accurate with this population because of their unique cultural and linguistic factors.

Setting: Deaf persons (n = 71) residing in southeastern Michigan.

Herb and vitamin supplementation use among a general ophthalmology practice population.

Purpose: To survey comprehensive ophthalmology patients about their use of vitamins and herbal supplements.

Design: Cross-sectional survey.

Methods: A survey instrument was developed and distributed to 397 patients presenting to a main campus university-based comprehensive ophthalmology clinic and to an off-site comprehensive ophthalmology clinic.

Interventions fail to increase cancer screening rates in community-based primary care practices.

Background: Cancer screening in primary care offices is reaching only a modest percentage of adults 50 years and older. The objectives of this study were to determine if screening rates for breast, cervical, and colorectal cancer could be significantly increased by two simple office interventions in community-based primary care offices and then maintained over 3 years.

Methods: Twenty-two community-based primary care practices were divided randomly into four arms: control, practice-based intervention, patient-based intervention, and both interventions combined.

Emergency contraception: knowledge and attitudes of family medicine providers.

Background And Objectives: Emergency contraception (EC) is an underutilized method of preventing unplanned pregnancy. This study assessed family physicians' and nurse providers' knowledge, attitudes, and beliefs about EC.

Methods: A cross-sectional survey was distributed to faculty, residents, and clinic nurses in a Midwestern department of family medicine.

Deaf persons and computer use.

Deaf person's computer use was studied (N = 227). Respondents self-administered a survey in their preferred language (voice, American Sign Language, captions, or printed English). A small nonparticipant sample was also recruited.

Candida transmission and sexual behaviors as risks for a repeat episode of Candida vulvovaginitis.

Objective: To assess associations between female and male factors and the risk of recurring Candida vulvovaginitis.

Methods: A prospective cohort study of 148 women with Candida vulvovaginitis and 78 of their male sexual partners was conducted at two primary care practices in the Ann Arbor, Michigan, area.

Results: Thirty-three of 148 women developed at least one further episode of Candida albicans vulvovaginitis within 1 year of follow-up.

Generalized vulvar dysesthesia vs. vestibulodynia. Are they distinct diagnoses?

Objective: To evaluate prospectively whether generalized vulvar dysesthesia and vestibulodynia possess unique characteristics that support the theory of differing etiologies.

Study Design: Women with vulvar dysesthesia for a minimum of 3 months were enrolled at the University of Michigan in 2 clinics specializing in vulvar disorders. Informed consent was obtained.

Depressive symptoms among women with vulvar dysesthesia.

Objective: The purpose of this study was to determine whether vulvar dysesthesia is associated with elevated depressive symptoms.

Study Design: This was a cross-sectional case-control study of women who underwent treatment of vulvar dysesthesia (n=32) or who were seen for a routine gynecologic examination (n=32). Subjects completed measures of depressive symptoms and pain and a sexual and medical history.

Sexual activities and attitudes of women with vulvar dysesthesia.

Objective: To assess the relationship between sexual activities and attitudes of women with and without vulvar dysesthesia.

Methods: Women with vulvar dysesthesia, 18-60 years old, and ethnically matched women without this disorder were enrolled in this cross-sectional study, completed a 27-page questionnaire, and had a physical examination. We compared sexual activities and attitudes between patients and controls using univariate and multivariable analyses.

Validating an instrument for selecting interventions to change physician practice patterns: a Michigan Consortium for Family Practice Research study.

Objectives: The goal of this study was to develop a psychometric instrument that classified physiciansamprsquo response styles to new information as seekers, receptives, traditionalists, or pragmatists. This classification was based on specific combinations of 3 scales: (a) belief in evidence vs experience as the basis of knowledge, (b) willingness to diverge from common or previous practice, and (c) sensitivity to pragmatic concerns of practice. The instrument will help focus efforts to change practice more accurately.

Primary care physician attitudes and values toward end-of-life care and physician-assisted death.

This study explores how primary care physician attitudes toward physician-assisted death (PAD) are related to their personal values toward end-of-life care and PAD. A group of 810 Michigan family physicians, internists, and general practitioners, divided into 4 typology groups by their intention toward participating in PAD, rated their attitudes toward PAD, along with their values and preferences for their own end-of-life care. Respondents who most objected to PAD were less likely to have executed an advance directive and more likely to have values promoting continued life-sustaining treatment in their own terminal care.

A multigenerational study on the correlation of values and advance directives.

The development of the Values History instrument for use in advance directive decision making has raised the question of the importance of values in eliciting advance directives. This pilot study examines the relationship between the domains of values and advance directives drawn from the Values History in three generation intrafamily triads. Significant correlations between values and advance directives were found primarily within the youngest generation.